George, Steven ZCoffman, Cynthia JAllen, Kelli DLentz, Trevor AChoate, AshleyGoode, Adam PSimon, Corey BGrubber, Janet MKing, HeatherCook, Chad EKeefe, Francis JBallengee, Lindsay ANaylor, JenniferBrothers, Joseph LeoStanwyck, CatherineAlkon, AvielHastings, Susan N2023-06-012023-06-012020-121526-23751526-4637https://hdl.handle.net/10161/27521<h4>Background</h4>Coordinated efforts between the National Institutes of Health, the Department of Defense, and the Department of Veterans Affairs have built the capacity for large-scale clinical research investigating the effectiveness of nonpharmacologic pain treatments. This is an encouraging development; however, what constitutes best practice for nonpharmacologic management of low back pain (LBP) is largely unknown.<h4>Design</h4>The Improving Veteran Access to Integrated Management of Back Pain (AIM-Back) trial is an embedded pragmatic cluster-randomized trial that will examine the effectiveness of two different care pathways for LBP. Sixteen primary care clinics will be randomized 1:1 to receive training in delivery of 1) an integrated sequenced-care pathway or 2) a coordinated pain navigator pathway. Primary outcomes are pain interference and physical function (Patient-Reported Outcomes Measurement Information System Short Form [PROMIS-SF]) collected in the electronic health record at 3 months (n=1,680). A subset of veteran participants (n=848) have consented to complete additional surveys at baseline and at 3, 6, and 12 months for supplementary pain and other measures.<h4>Summary</h4>AIM-Back care pathways will be tested for effectiveness, and treatment heterogeneity will be investigated to identify which veterans may respond best to a given pathway. Health care utilization patterns (including opioid use) will also be compared between care pathways. Therefore, the AIM-Back trial will provide important information that can inform the future delivery of nonpharmacologic treatment of LBP.HumansLow Back PainTime FactorsVeteransRandomized Controlled Trials as TopicPain ManagementSurveys and QuestionnairesJournal article2023-06-01